James Reilly (Dublin North, Fine Gael) | Oireachtas source

I thank the Deputies opposite. We covered this area last week in the Chamber and again yesterday at Question Time. I understand that in different parts of the country, different concerns are raised but I welcome the opportunity to outline again the current position relating to our pre-hospital emergency care services.

The National Ambulance Service, NAS, is working to ensure the provision of high quality and timely emergency pre-hospital care services using all available resources as effectively and as efficiently as possible. As with any pre-hospital service, development and modernisation is an ongoing process as technology and clinical standards change. A significant reform programme is under way and additional funding of €3.6 million and 43 staff have been provided in the 2014 national service plan. I believe it is important that we acknowledge that progress is being made.

New governance arrangements are being put in place to ensure the timely assessment, diagnosis, initial management and transport of acutely ill patients to appropriate care. A joint review of Dublin ambulance services, commissioned by Dublin City Council and the HSE, will determine the best model of ambulance services for the city, although I know this does not concern any of the Deputies here. In addition, an independent review of the NAS capacity nationwide will determine the level and use of resources required in terms of staff, vehicles, skills and distribution, for a safe and effective service now and into the future. I am confident that the reports of these reviews will inform the development of a modem, clinically-driven system, properly resourced, for appropriate and timely services to the benefit of patients.

Deputy Kitt raises the issue of services in north Galway and south Mayo. The national capacity review, as well as the HIQA review, will be of importance in the context of the development of services outside the main urban areas and, in particular, the western area which, because of its rural nature and road network, provides a particular challenge for response time targets. The counties in question benefit from the Emergency Aeromedical Support, EAS, service. This service provides rapid air transport of seriously ill or injured patients to an acute facility, where the land transit time would not be clinically advisable. The EAS has completed 556 missions since its inception in June 2012 to February 2014. The Irish Coast Guard also performed over 300 helicopter missions in support of the NAS in 2013 and will continue to do so in 2014.

I would like to assure the House that the NAS will continue to modernise and reconfigure its services to deliver timely and appropriate emergency pre-hospital care. The ongoing reform programme will provide a clinically driven, nationally co-ordinated system, supported by improved technology.

Deputy Ó Cuív's commented on the golden hour but things have moved on in that regard. The critical period now is 90 minutes for somebody with an acute myocardial infarction or a heart attack which requires a bypass, which is now done through stenting. All patients going to the relevant centres can avail of this and the outcomes have been hugely improved for people who suffer heart attacks. There have also been huge improvements in the numbers of stroke patients who receive thrombolysis, the blood clot busting agent, which relieves their symptoms, saving at least a life a week and preventing three people per week from going into long-term care. We have gone from the bottom of the list in Europe for such procedures to the very top in a very short timeframe of 18 months.

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